Skip to main content

Full text of "Navy and Marine Corps Medical News February 2009"

See other formats


World Class Care. ., Anytime, Ajiywhere 

Issue 2 
February 13, 2009 

Inside this Issue : 

Admiral's Call by the Surgeon 
General of the U.S. Navy 
Vice Admiral Adam. M. 

Lejeune Corpsman Awarded 
Bronze Star 

Deployed Audiologist, Corpsman; 
and Clinic OIC Recognized for 

Psychological Health, Traumatic 
Brain Injury Outreach Center 

Bremerton HM Renders Emergency 5 
Medical Aid on Flight 

Portsmouth Hospital Innovates 
Vaccine Tracking of Staff 

Naval Hospital Camp Pendleton 
Provider Recognized 

NMCSD Leads the way in Tg 

Implementation of WHO Surgical 


New Navy Center Promotes 
Strength Through Mental Health 

Item of Interest: 

February is American Heart Month. 

About every 25 seconds, an American 
will have a coronary event. Learn more 
about coronary heart disease, which 
often appears as a heart attack and is 
the most common heart disease in the 
U.S. In fact, heart disease is the num- 
ber one cause of death in our nation. 
To learn more about maintaining a 
healthy heart, visit http:// 

Navy and Marine 
Corps Medical News 

A Public Affairs Publication of the Bureau of Medicine and Surgery 

Caregivers Learn to Take Care of Self 

By Mass Communication Specialist 
2nd Class Stephanie Tigner and 
Mass Communication 1st Class 
Cindy Gill, Navy Medicine West Pub- 
lic Affairs Office 

SAN Dl EGO - Medical care pro- 
fessionals business is caring for 
others. Often overlooked is care for 
the caregivers themselves particu- 
larly those who serve in intense 
situations like disasters and battle- 
fields. The Navy Medicine Care- 
giver Occupational Stress Control 
(OSC) progrann training teann re- 
cently provided stress nrianagement 
training to approximately 90 Navy 
medical caregivers from around the 
world at the Westin Hotel here. 

Informally known as Care for 

the Caregiver, the training focused 
on understanding occupational and 
compassion fatigue, caregiver 
stress and burnout. Left unrecog- 
nized, accumulated stressors could 
lead to medical errors, job dissatis- 
faction and poor retention. 

"The goal is that we have 80-90 
people that have some new skills 
and some new training, and the 
training will provide them a new 
insight into work that they can do in 
their own command and support 
that they can provide to others," 
said Rear Adm. Karen Flaherty, 
Deputy Chief, Wounded, III and In- 
jured. "Part of that is making sure 

(Continued on page 3) 

WASHINGTON - Rear Adm. Thomas Cullison (far left), Deputy Surgeon General, and FORCE 
Master Chief Laura Martinez (far right). Bureau of Medicine and Surgery (BUMED), congratu- 
lated the nominees for Navy Medicine (NM) Shore Sailors of the Year (SSOY) 2008 Feb. 4. 
Hospital Corpsman 1^* Class (HMl) Kelvin Chatman (left next to Martinez), NM East, was named 
NM SSOY 2008. The nominees also included (from left to right) HMl Stacey Stallings, NM Sup- 
port Command; HMl Dante Cooley, NM National Capital Area; HMl David McCarter, NM West; 
and HMl Donna Gray, BUMED. U.S. Navy photo by Christine Mahoney 

Admirars Call by the Surgeon General of the U.S. Navy 
Vice Admiral Adam. M. Robinson, Jr. 

Navy Medicine Caregiver Occupationai 

Stress Controi Program 

Care for ttie Caregiver - Buiiding Resiiience 

The passion and dedication each 
of us brings to our caregiver role is 
both a strength and a vulnerability. 
We -- Navy Medicine -- are who we 
are and do what we do because of 
our comnriitment to care for others. 
Some tinnes in our caregiver roles 
we forget to care for ourselves. J ust 
as Sailors and Marines need us to 
be there for them; we need to give 
ourselves permission to be there for 
each other as Shipmates and to 
recognize when a Shipmate is 
reaching out in a time of need. 

To provide the best healthcare 
to our wounded warfighters, their 
families and other beneficiaries, 
every Navy Medicine caregiver must 
make a personal commitment to 
stay physically and emotionally 
healthy. To address this concern, 
the Bureau of Medicine and Surgery 
has developed the Navy Medicine 

Caregiver Occupational Stress pro- 
gram. This program is tied to the 
initiatives of the Commandant of 
the Marine Corps, the Chief of Naval 
Operations and the Secretary of the 
Navy to do what is right for all of 
our Sailors and Marines. 

I n the next few months, you 
will hear more about this program 
as members of the training teams 
visit your commands. One of the 
main strategies behind this pro- 
gram is the development of multi- 
disciplinary occupational stress 
training for personnel at our mili- 
tary medical treatment facilities. 
Recently the BUMED Caregiver Oc- 
cupational Stress Control Program 
training team provided stress man- 
agement training in San Diego to 
about 90 Navy health care provid- 
ers from MTFs and naval clinics. 
The BUMED Caregiver training team 

intends to follow up with each of 
the commands represented at the 
San Diego training within the next 
six to eight months to conduct on- 
site training for additional person- 

Our Navy Medicine Caregiver 
Occupational Stress Program ad- 
dresses three fundamental princi- 

( Continued on page 4) 

Lejeune Corpsman Awarded Bronze Star 

By Raymond Applewhite, Naval Hospital Camp Lejeune 
Public Affairs Office 

CAMP LEJEUNE, N.C. - Capt. Gerard Cox, Com- 
manding Officer, Naval Hospital Camp Lejeune (NHCL) 
presented the Bronze Star to Hospital Corpsman 2nd 
Class Stephen Bias in a ceremony held at Naval Hospital, 
Jan. 14. 

Bias, a general duty hospital corpsman 2nd class, 
was awarded the Bronze Star for prolonged medical ser- 
vices rendered to an injured soldier during combat in 
support of Operation Enduring Freedom, while serving 
with Embedded Training Team, (ETT) Medical Non- 
commissioned Officer Mentor for HHC, 2""^ Battalion, 2""^ 
Brigade, 205^^ Corps, Afghan National Army (ANA) and 
primary medical provider for 2-2-205^^ ETT's. 

During combat operations, he executed his duties in 
an exceptional manner at several of the most dangerous 
locations within the Islamic Republic of Afghanistan. He 
assisted his ANA and ETT's in four troops-contact and 
two Improvised Device (I ED) attacks. He was the first 
medical personnel to respond to the I ED attack where he 
provided immediate attention to a Solider. A medical 
evacuation was not available. Bias risked his own life 
riding in the back of an ANA 7-ton truck exposing him- 

self to enemy attack to continue treating his patient. 

In a separate attack against his unit, they found 
themselves out numbered and pinned down with a mal- 
functioning weapon. Bias dismounted the vehicle and be- 
gan to return fire with his personal weapon. While on an- 
other patrol, his unit came under direct enemy fire, which 
resulted in his executive officer suffering from shrapnel 
wounds and suspected traumatic brain injury (TBI). A 
MEDEVAC flight was requested, but not available. Bias 
continued medical care throughout the night for 15 hours 
until the patient could be successfully evacuated. Bias is 
credited with saving his executive officer's life. During 
another attack, a U.S. Soldier and U.S. interpreter trig- 
gered a deadly I ED fatally wounding two Soldiers and 
wounding another U.S. Soldier and U.S. interpreter. Bias 
stabilized the Soldier and the interpreter and remained 
with them until they could be evacuated. 

"Giants stride across the face of the earth every day 
and today, a true hero walks among us," said Capt. 
Gerard Cox, Commanding Officer, NHCL. 

"I am very proud and honored to receive this award. 
It was a team accomplishment related to the mission that 
we were there to do. I am very proud to represent Navy 
Medicine there and here," said Bias. 

Caregivers continued... 

(Continued from page 1) 

that there is a self awareness of your own health, that 
there are things that you can do personally to improve 
your overall health and as a result the support we can 
provide to the wounded is better." 

The Caregiver OSC program focuses on three funda- 
mental principles: early recognition, peer intervention 
and connection with services as needed, according to 
Capt. Richard Westphal, mental health clinical specialist 
at the Navy's Bureau of Medicine and Surgery in Wash- 
ington D.C., and designer of the caregiver program. 

Westphal said no matter what their role. Sailors 
need to recognize early warning signs of distress and 
intervene. The goal is to provide caregiver intervention 
and resources before pressure have impaired the indi- 
vidual's ability to be effective. 

Topics covered during the conference included 
buddy care assessment and intervention, self care, 
compassion fatigue skills and work environment assess- 

"This is tied to the Commandant of the Marine 
Corps, the Chief of Naval Operations and the Secretary 
of the Navy's initiatives to do what is right for all of our 
Sailors and Marines, and part of what we're doing is 
figuring out how to do right by our caregivers," said 

Several tools presented by Westphal include After 
Action Reviews, Combat and Operational Stress First 
Aid, self modulation skills, core leader functions, a 
stress injury decision matrix and Operational Stress 
Control and Readiness (OSCAR) communication. 

OSCAR communication consists of Observing behav- 
iors. Stating the observations. Clarifying role and your 
concern about the behavior. Ask why to seek clarifica- 
tion of the behaviors and Respond with guided options. 

After Action Review is a tool for small groups led at 
the unit level following a significant event. The reviews 
are for caregivers to understand what happened and 
why, anticipate and address problems particularly loss 
of confidence and excessive self- blame or over- 

After Action Reviews provide an opportunity to as- 
sess the health and readiness of the unit and its mem- 
bers as well as support unit cohesion and reinforce 

shipmate and buddy dialog. After action reviews also cre- 
ate an opportunity for future healing if needed. 

Combat and Operational Stress First Aid (COSFA) is 
similar to basic life support in that it combines assessment 
and getting help with effective actions. The seven C's for 
helping a shipmate Check, Coordinate, Cover, Calm, Con- 
nect, Competence, and Confidence. Check - look, listen, 
assess. Coordinate - get help, refer as needed. Cover - 
quickly get to physical or emotional safety. Calm - slow 
deep breaths, slow heart rate, begin to relax. Connect - 
get support from others. Competence - restore effective- 
ness. Confidence - restore trust in self, others, and mis- 

Self modulation or Subjective Units of Disturbance 
Scale (SUDS) is a zero to 10 scale for measuring the sub- 
jective intensity of distress. 

Core Leader Functions are designed for leaders to 
strengthen the unit, identify stress loads and recognize 
reactions, injuries and illnesses; mitigate by ensuring ade- 
quate sleep and rest along with removing unnecessary 
stressors, treat through chaplains and medical services 
and finally, reintegrate a unit member who has been 

The Operational Stress Control Decision Matrix is a flow 
chart with 'yes' and 'no' directions to help guide leaders 
and peers to assessing the potential severity of a Sailor's 
stress levels. The four color chart begins with green for 
ready followed by a yellow zone as a flag for someone re- 
acting. Upper zones are orange for injured followed by red 
to indicate medical intervention. 

"We must interrupt the cycle of stress as early as pos- 
sible," said Westphal. "If we do that for our shipmates 
then the need for high-end mental health services is re- 
duced, we get a reduction in non-judicial punishments and 
a reduction in destructive behavior." 

Westphal said he has had tremendous positive feed- 
back from participants of the training. 

"It's very helpful and I really appreciate this training," 
said Chief Hospital Corpsman Straussi Mumford of Naval 
Hospital Camp Lejeune in North Carolina. "This is informa- 
tion that I can take back to my command to help out." 

Westphal and the rest of the Caregiver OSC program 
team members intend to follow up with each of the com- 
mands' represented at the conference within the next six 
to eight months to conduct training for all personnel. 

Deployed Audiologist, Corpsman; and Clinic QIC Recognized 
for Service 

By Mass Communications Specialist 1^^ Class (AW) Rus- 
sell C. Tafuri, Naval Hospital Pensacola Public Affairs Of- 

PENSACOLA, Fla. - Naval Hospital (NH) Pensacola 
Commanding Officer, Capt. Maryalice Morro, Nurse 
Corps, presented awards at an informal awards cere- 
mony in front of the hospital following morning colors 
Friday, January 30^^. 

Lt. Cmdr. Kimberly Gullickson, Regional Audiologist 
for Naval Hospital Pensacola's Public Health directorate 
was presented her third career Navy Commendation 
Medal for here clinical services at Naval Branch Health 
Clinic (NAS) Pensacola. 

During her tenure, Lt. Cmdr. Gullickson ran all oc- 
cupational audiology services for more than 25,000 
active duty military personnel and civil service employ- 
ees in the Pensacola hospital's region. Also during this 
period, Gullickson supported the global war on terror- 
ism when deployed to Guantanamo Bay, Cuba, where 
she fit hearing amplification devices for detainees, 
thereby establishing audiometric testing facility specifi- 
cations for the detention facility. 

Lt. Cmdr. Michael S. Kohler, officer-in-charge of 
NBHC (NAS) Pensacola, was presented his fifth career 
Navy Achievement Medal for his professional achieve- 
ment and performance NH Pensacola's Operational 
Training Officer from September 2007 to August 2008. 

Kohler developed and directed a complex opera- 
tional training program designed to encompass all plat- 
form training requirements into a single plan which had 
an immediate readiness impact for more than 350 per- 

Surgeon General's Column continued... 

PENSACOLA, Fla. - Naval Hospital Pensacola military staff members 
were recently presented personal awards at a January 30 awards cere- 
mony. They are (from left) Lt. Cmdr. Kimberly Gullickson; Lt. Cmdr. 
Michael S. Kohler; and Hospital Corpsman Third Class Rachel Dejong. 
U.S. Navy photo by Mass Communications Specialist 1^* Class (AW) Rus- 
sell C. Tafuri 

sonnel monthly. 

He also augmented training to support mission- 
performance standards that included 25 baseline pre- 
deployment requirements that culminated in a successful 

(Continued on page 6) 

(Continued from page 2) 


Early Recognition - Trust your instincts when you 
think a Shipmate is struggling. Help caregivers by cre- 
ating awareness of occupational stress and compassion 
fatigue. Help individuals, units, and commands develop 
resources to detect occupational stress factors that have 
potential negative impact on professional and personal 

Peer I ntervention - Break the code of silence. 
Peers, Shipmates, friends and family members will be 
the first to recognize when occupational stress begins to 
undermine professional and personal performance, and 
they need to be prepared to talk about their concerns. 
Building networks of supportive colleagues and friends 
who provide unconditional acceptance and support can 
help with complicated situations. These can act as men- 
tors and provide referrals to support resources. 

Talce Action - Engage with the appropriate level of 
support or assistance. Providing timely and proactive 
support to our caregivers working in high stress health- 
care environments increases options and choices. Start 

with individual skills for reducing negative stress reac- 
tions, unit discussions to address unnecessary work 
stress, and command dialogues about balancing mission 
demands and available resources. 

This program is designed to enhance individual resil- 
ience, strengthen unit cohesion, and support command 
level assessment of the work environments of caregivers. 
We are also creating trained intervention teams, with a 
mix of officer and enlisted, at our major MTFs. With this 
training and the intervention teams, we will expand our 
caring network and provide our caregivers with skills and 
knowledge about: stress first-aid; buddy care assess- 
ment and intervention; self care/ compassion fatigue 
skills; work-environment assessment; and education out- 

Job stress and compassion fatigue can undermine our 
professional and personal performance. They can have a 
detrimental impact on our job satisfaction and result in 
poor retention. Navy Medicine is a uniquely diverse 
team. Each of us brings our individual skills and talents 
to the table and we need to learn to recognize when we, 
as caregivers, must take a step back, and take some time 
to care for ourselves before re-engaging in the battle. 

Psychological Health, Traumatic Brain Injury Outreach Center 

U.S. Department of Defense Office 
of the Assistant Secretary of De- 
fense (Public Affairs) 

WASHINGTON - The Depart- 
ment of Defense (DoD) today an- 
nounced the opening of a 24-hour 
outreach center to provide informa- 
tion and referrals to military service 
members, veterans, their families 
and others with questions about 
psychological health and traumatic 
brain injury. 

The new center, which is oper- 
ated by the Defense Centers of Ex- 
cellence for Psychological Health 
and Traumatic Brain Injury (DCoE), 
can be contacted around the clock, 
365 days a year, by phone at (866) 
966-1020 and by e-mail at re- 
sources(a) . 

"We're providing 24/7 support to 
assist callers with questions regard- 
ing psychological health and trau- 
matic brain injury," said Brig. Gen. 

Loree K. Sutton, M.D., director of 
DCoE. "Getting the best possible 
information and tools, hassle-free, 
will empower and strengthen warri- 
ors and their families to success- 
fully manage what can be confusing 
and disturbing circumstances." 

The center can address every- 
thing from routine requests for in- 
formation about psychological 
health and traumatic brain injury, 
to questions about symptoms a 
caller is having, to helping callers 
find appropriate health care re- 

DCoE promotes resilience, re- 
covery and reintegration of service 
members facing psychological 
health and traumatic brain injury 
issues. DCoE works to advance re- 
search, education, diagnosis, and 
treatment of these conditions. 

"If we need to research a ques- 
tion, we'll do the legwork and 
quickly reconnect with callers," Sut- 

ton said. "We welcome feedback on 
how we can better meet the needs 
of those we are so privileged to 

The DCoE outreach center is 
staffed by behavioral health con- 
sultants and nurses, most with 
master's degrees. In addition to 
answering questions, staffers refer 
callers to contact centers in other 
parts of DoD, other federal agen- 
cies, and outside organizations 
when appropriate. Other contact 
centers also refer callers to the 
DCoE outreach center. 

The center serves members, 
leaders and healthcare providers of 
the Army, Navy, Air Force, Marines, 
Coast Guard, National Guard, Re- 
serve, and all uniformed services, 
along with veterans of all the ser- 
vices. The families of service mem- 
bers and of veterans are also 
served by the new center. 

Bremerton HM Renders Emergency Medical Aid on Flight 

By Douglas H Stutz, Naval Hospital Bremerton Public 
Affairs Office 

BREMERTON, Wash. - Hospital Corpsman 3rd 
Class (FMF) Bryce Moheit had to wait to take his wife 
Amanda on their honeymoon. But there was no hesita- 
tion on his part when immediate medical assistance 
was needed. 

Approximately one hour into the four-hour American 
Airline Flight 2033 from Dallas/Fort Worth to Seattle 
January 6, Moheit and other passengers were asked 
over the public address system if there were any 
trained medical personnel on board. Bryce and 
Amanda, Bristol, Tenn., natives who have known each 
other since high school, were flying back to Naval Hos- 
pital Bremerton (NHB) after spending their honeymoon 
in Orlando, Fla. Their celebratory vacation had been 
earlier postponed due to his deployment with the 3^^^ 
Battalion, 5^^ Marine Regiment to Iraq, which had had 
already pushed back their marriage timetable until after 
he returned. 

"I pushed the call button and told the stewardess I 
was a Navy Hospital Corpsman and a field medical ser- 
vice technician," said Moheit, who then followed the 
flight attendant to the back of the plane. There, Moheit 
found a 14-year old boy in obvious pain. Urgency was 
added to the situation by the fact the young man was 
flying unaccompanied without an adult. 

"The teen was in a lot of pain," Moheit related. "He 
was lying down and writhing on the deck. I proceeded 

to do an evaluation on him. I asked him some basic ex- 
amination questions, took his vitals and got a quick his- 
tory. He was in acute pain in his groin area, specifically his 
left testicle. He also vomited from the pain, which he man- 
aged to relay had just suddenly started." 

Moheit calmly took charge and explained what he was 
doing to his new patient. He professionally passed the 
responses he received to the plane captain, who in turn 
communicated to an American Airlines doctor on the 
ground. Aided by another passenger who was a certified 
first aid provider, Moheit then gloved up and did a brief 

"I found he had significant swelling in his scrotum," 
explained Moheit, again passing the information on to the 
physician on the ground. 

It was then suspected and later verified that the young 
man was suffering from testicular torsion, a very painful 
condition caused by the twisting of the testicle, which 
compromises blood flow to the testicle. Torsion is the most 
common cause of testicular loss in adolescent males. The 
condition is a surgical emergency and can result in the loss 
of the affected testicle if not treated promptly. 

"On the pain scale of one to 10, it was a seven, which 
immediately went up to nine by any pressure on that im- 
pacted area," Moheit said. "He first thought he would be 
okay if he could just find a position to get comfortable. But 
every position was agony for him. It was at that time de- 

( Continued on page 7) 

Portsmouth Hospital Innovates Vaccine Tracking of Staff 

By Deborah Kallgren, Naval Medical Center Portsmouth 
Public Affairs Office 


Millions of Americans get a flu shot each year. But what 
about the health care providers who administer the 
shots and take care of the patients? Do they take the 
same precautions? 

Those questions can be answered quite thoroughly 
this year at Naval Medical Center Portsmouth (NMCP), a 
298-bed hospital with more than 5,000 staff members. 
A digital conduit connecting existing databases can now 
quickly and accurately pinpoint the providers who have 
and have not been immunized against influenza this 

"We are the first Military Health System medical 

Pensacola continued... 

treatment facility to reach a 90 percent compliance rate 
and we did it by Nov. 1, 2008, before the traditional flu 
season started, thereby protecting our patients from the 
flu," said CherylAnn Kraft, Regional Immunization Pro- 
gram Manager at NMCP. "Is your doctor living the advice 
he's giving you? We are here at Portsmouth." 

By integrating data from electronic health records and 
human resources, a Web- based system was designed and 
implemented to identify hospital and clinic staff who had 
received their flu immunization and those who were ex- 
empt. The Automated Staff I nfluenza Vaccination Track- 
ing system replaced error- prone and labor-intensive 
spreadsheets in which the data had to be entered by 

(Continued on page 8) 

(Continued from page 4) 

mass casualty exercise involving 
three local commands. 

Hospital Corpsman 3rd Class 
Rachel Dejong, assistant to the 
hospital Command Master Chief, 
was presented with the U.S. De- 
partment of Defense Humanitarian 
Service Medal for her service while 
deployed to Tbilisi, in the Republic 
of Georgia, in support of Operation 
Assured Delivery, where humanitar- 
ian relief assistance was provided 
following hostilities with the Russian 

Federation between last summer. 
Milo J . J ablonski, medical sup- 
port assistant for the Laboratory, 
Occupational Therapy and Radiol- 
ogy departments, was presented a 
Career Service Award, signed by 
the Secretary of the Navy Donald C. 
Winter, in "grateful recognition and 
appreciation" of his 40 years of 
faithful service to the U.S. Navy 
and to the government of the U.S. 
He was presented a service pin, a 
framed photo of former President 
George W. Bush, and a certificate of 

Barbara Cotton, administrative 
assistant in the Laboratory and 
Clinical Pathology departments was 
presented a government service 
recognition pin and certificate for 
her faithful and loyal 25 years of 

Donna K. Griffin-Jenkins, a fi- 
nancial technician for the Director- 
ate for Resource Management, was 
presented a government service 
recognition pin and certificate for 
her faithful and loyal 20 years of 

Naval Hospital Camp Pendleton Provider Recognized 

By Mass Communications Specialist 
2nd Class( AW) Paul Sheets, Naval 
Hospital Camp Pendleton Public Af- 


Navy-wide survey of occupational 
health clinics conducted from Oct. 
26, 2007, through Dec. 30, 2008, 
by the Navy Bureau of Medicine and 
Surgery, named Harry R. Sullivan, 
a Physician Assistant at Naval Hos- 
pital Camp Pendleton (NHCP), as 
the Navy's top occupational health 
provider in overall patient satisfac- 

The report was on productivity 
and patient satisfaction among all 
occupational health clinics in Navy 

With 20 years as a Navy Hospi- 
tal Corpsman, Sullivan retired from 
active duty and went on to work for 

the U. S. Justice Department. 
While there, he was certified as a 
Physician Assistant by the U. S. 
Public Health Service. His Naval 
service, 11 years at the J ustice 
Dept., and 24 years at NHCP, gives 
him more than 50 years of provid- 
ing medical care. 

When asked what he felt about 
ranking top in patient satisfaction, 
Sullivan, 75, had this to say, "I was 
surprised. There are so many guys 
out there better than me. I just try 
to do the best I can. I really care 
for these people, they're my family. 
I don't treat my patients like 
strangers, but like someone I 

Often times Sullivan does know 
his patients. A favorite at the clinic, 
he has many regulars at Marine 
Corps Base Camp Pendleton includ- 

ing personnel from base police and 
firefighters. According to Kurt Bo- 
wen, NHCP occupational health 
technician, his regulars request to 
see him specifically even if they 
have to wait. "They stop by some- 
times just to say 'hi' and talk with 
him," said Bowen. 

"This report tells us what we 
already knew, our Occupational 
Health staff are a great team, lead- 
ing the pack and living Hero- 
Centered Care in taking care of 
those who depend on us," said 
Capt. Forrest Faison, commanding 

The report named NHCP as the 
top producing occupational health 
clinic. Naval Branch Health Clinic 
Port Hueneme ranked first and sec- 
ond place in satisfaction for en- 
counters and access respectively. 



NMCSD Leads the way in Implementation of WHO Surgical 

By Mass Communication Specialist 
2nd Class Alexander Ameen, Naval 
Medical Center San Diego Public 
Affairs Office 

SAN DIEGO - Naval Medical 
Center San Diego (NMCSD) recently 
inriplemented a pilot progrann to test 
a new surgical checklist aimed at 
improving communication and pro- 
viding a more comprehensive way 
for surgical teams to perform op- 

The checklist is based on a new 
format developed by the I nstitute 
for Healthcare Improvement (I HI) 
at the request of the World Health 
Organization (WHO). 

Capt. Jose Acosta, Director of 
Surgical Services at NMCSD, said 
two departments at the hospital are 
already using the checklist. 

"I attended the I HI conference 
in December where the checklist 
was introduced," Acosta said. "As 
soon as I got back to San Diego we 
put a team together to assess ex- 
actly how we would implement the 
checklist asap." 

Acosta said NMCSD had a 
"Surgery Time Out" system in place 
which allowed a surgical team to 
take a moment before making an 
incision to double-check their infor- 
mation, but the new checklist is 
much more thorough. 

The standard WHO check lists 

Flight continued... 

(Continued from page 5) 

termined that an emergency landing was necessary and 
the flight was diverted to Salt Lake City." 

Testicular torsion mostly happens in the 12-18-year- 
old age group. Besides being extremely painful, there is 
sudden swelling which develops as the structures twist 
and the testicle elevates. Nausea, vomiting and abdomi- 
nal pain are also often experienced. 

"When we landed at Salt Lake City, the paramedics 
came on and we did a turnover. They did a quick assess- 
ment and agreed on what I already passed on and then 
immediately took the young man off for treatment," said 
Moheit. "Then the entire flight crew came over to thank 
me for my efforts on his behalf." 

Medical experts state that the only treatment for tes- 
ticular torsion is surgery. 

"The medical help that Moheit provided was vital be- 

includes 19 steps such as making 
sure the patient has identified him- 
self and given consent, confirming 
all surgical team members have 
introduced themselves by name 
and role, and confirming instru- 
ment, sponge and needle counts 
are correct. The checklist can be 
modified to better suit the needs of 
individual facilities. 

"We did customize the checklist 
a little, adding steps such as mak- 
ing sure the proper equipment is 
available and administering prophy- 
laxis to prevent blood clots," Acosta 

The WHO checklist was devel- 
oped in response to statistics show- 
ing that out of more than 234 mil- 
lion people world wide that will 
have major operations this year, 
approximately one percent will die 
from complications that could have 
been prevented. 

According to a special article 
recently appearing in the New Eng- 
land J ournal of Medicine, eight hos- 
pitals in eight cities around the 
globe, representing a variety of 
economic circumstances and di- 
verse populations of patients, par- 
ticipated in testing the new check- 
list between October 2007 - Sep- 
tember 2008. 

Use of the checklist in these 
eight hospitals was associated with 

SAN Di EGO - Melissa Canedo, a Naval 
Medical Center San Diego (NMCSD) regis- 
tered nurse, scans the World Health Organi^ 
zation (WHO) Surgical Check List before ^| 
proceeding to the next phase in the operat^^ 
ing procedure. U.S. Navy photo by Mass 
Communication Specialist 3rd Class Jake 

a reduction of the death rate from 
surgery by almost half and the re- 
duction of complications by more 
than a third. 

cause it is extremely important to have such a condition 
as testicular pain evaluated as soon as possible," com- 
mented Chief Hospital Corpsman Emiliano Rabor, NHB 
Main Operating Room Leading Chief. "Moheit's remark- 
able action provided a favorable outcome." 

Thomas N. Bettes, M.D., M.P.H., Director, Medical 
and Occupational Health Services for American Airlines 
sent a formal thank you to Moheit. "We are all grateful 
that you were on board and freely offered your medical 
expertise when it was needed most. Without a doubt, 
you greatly improved a difficult situation." 

"I only did what any other corpsmen would have 
done," said Moheit. "We're trained for such an emer- 
gency. I was just the right place at the right time for the 
young man. Even though he was in a lot of pain, he did 
look more relaxed when he knew I was a Navy hospital 
corpsman with the necessary medical experience." 

IFebruary IJ 


New Navy Center Promotes Strength Through Mental Health 

By Mass Communications Specialist 2"'' Class (AW) Greg 
Mitchell, Naval Medical Center San Diego Public Affairs 

SAN Dl EGO - A new Navy program dedicated to 
restoring, protecting and building the mental health of 
Sailors, Marines and their families is now open at Naval 
Medical Center San Diego (NMCSD). 

The major focus of the Naval Center for Combat Op- 
erational Stress Control (NCCOSC) is to promote the 
best practices in diagnosis and treatment of posttrau- 
matic stress disorder (PTSD) and traumatic brain injury 
(TBI), conditions that have become synonymous with 
the unique demands placed on the armed services fight- 
ing the Global War on Terror. 

Another key component of the center is to identify 
and incorporate into training the psychological resilience 
factors shown to help prevent stress injuries and to pro- 
mote force readiness. Resources to aid families in ad- 
justing to deployments -- as well as to assist in coping 
with problems that might arise after a service member's 
return -- are also emphasized. 

"NCCOSC highlights the change in Navy and Marine 
Corps culture to make certain that our troops are psy- 
chologically fit to meet the demands of the 21^^ century 
and new global realities," said Capt. Paul S. Hammer, 
MC, USN, director of the center. 

"Understanding that the enemy's purpose is to inflict 
combat stress on us, then at controlling stress is as es- 
sential as controlling the bleeding from a penetrating 
wound," according to Hammer. 

"We want to help not only those in distress, but to 
promote good stress management for everyone that 
lasts from boot camp to war college," Hammer added. 

Vaccine Tracking continued... 

(Continued from page 6) 

"We must get past just dealing with people in crisis and 
instead promote a system that increases our ability to 
cope so that we rarely get into a crisis mode." 

According to some studies, including one released in 
April 2008 by the Rand Corp., as many as 20 percent of 
combat troops who have served in Iraq or Afghanistan 
have PTSD or a major depressive disorder. About 
300,000 have experienced a probable TBI. 

Attending the J an. 16 grand opening of the NCCOSC 
were Rear Adm. Christine S. Hunter, Commander, 
NMCSD; and Rear Adm. Karen Flaherty, Deputy Chief for 
Wounded, III and Injured, at Bureau of Medicine and Sur- 
gery (BUMED). NMCSD has administrative oversight of 
the new center which receives its funding from BUMED in 
Washington, D.C. 

"We have made exceptional progress in helping 
wounded service members to recover physically and to 
rebuild their lives," said Hunter. "NCCOSC helps us to 
now focus on those whose wounds are hidden, to help 
them recover psychologically and to support their families 
through education and all available services." 

In remarks, Flaherty acknowledged the important role 
of the center. 

"This center is the result of a vision by many of you 
here today. A vision of what we could do to help under- 
stand the effects of stress on our warriors, our Marines, 
and our Sailors," said Flaherty. "We know that stress 
reactions increase with prolonged exposure in combat 
and we know that some individuals appear to have more 
challenges than others even though all are affected. We 
also know that resiliency can assist with recovery. This 
center will be key in our discussions and discovery." 

hand. Plus, the new system re- 
quired no start-up costs. 

The result: the medical center 
has achieved a staff vaccination 
compliance rate of 96.5 percent this 
flu season, which includes 3.4 per- 



World Class Care, . .Anytime, Anywhere 

bureau of Medicine and Sun 

2300 E Street NW 
Washington, DC 20372-5300 

Public Affairs Office 

Phone: 202-762-3221 

Fax: 202-762-1705 

cent exemptions. For the 2006- 
2007 flu season, the Centers for 
Disease Control noted a 42 percent 
vaccination rate among its medical 
personnel. I n 2008, the J oint Com- 
mission noted 43 percent as a rate 
worthy of recognition in its Flu Vac- 
cination Challenge. 

Kraft said, "The flu rate is up in 
Hampton Roads this year, but 
(NMCP's) diagnosed flu rate is down 
from last year. When more provid- 
ers get flu shots before flu season, 
then they do not pass the flu to 
their patients." 

Staff satisfaction in the Immu- 
nization Department is similarly 
high. Desiree Sanders, registered 
nurse said, "This has saved me tons 
and tons of time. I used to have to 
update the spreadsheets manually 

every night to prepare a new list for 
department heads the next morn- 
ing." With the new process, the 
lists and codes are matched up 
every two hours and Sanders has 
only to troubleshoot the resulting 

Kraft added, "This new system 
has truly changed our time man- 
agement; instead of doing adminis- 
trative work, it has given us time 
back to take care of our patients." 

The Vaccination Tracking sys- 
tem also supports the Joint Com- 
mission National Patient Safety 
Goal #10.01 (Annual Influenza Vac- 
cination). The system has been so 
successful, it has been shared with 
other naval hospitals as an example 
of how to streamline their staff in- 
fluenza vaccination tracking. 

Got News? If you'd like to submit an article or have an idea for one,